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Fibromyalgia and Chronic Fatigue, Where Do I Start?

by Patricia Keplinger RN BSN and Chris Ritchason

Fibromyalgia and Chronic Fatigue Syndrome provide an interesting set of signs & symptoms which continually perplex licensed medical doctors and natural health practitioners alike.

As early as 1987, fibromyalgia has been recognized by the American Medical Association as a valid illness and major cause of disability. In 1990, The American College of Rheumatology (ACR) published criteria for the diagnosis of fibromyalgia and it was at that time the official diagnosis became recognized.

Yet, it is not considered a disability according to the American Disabilities Act. When an individual becomes unable to function due to this subset of symptoms, they must expand on each individual problem that causes a decrease in functioning and not just rely on the label.

Individuals who encounter fibromyalgia and chronic fatigue syndrome are known to become very discouraged because there are no tests that specifically diagnosis the illness, pinpoint the cause of the symptoms, nor are there set plans of attack for dealing with these illnesses.

Although there is no generally accepted test to accurately detect the diseases, the Centers for Disease Control and Prevention states that more than one million Americans suffer from CFS and estimates that FM affects about 2 percent of the U.S. population and affects more females than males, with a ratio of 9:1 by ACR criteria. It is most commonly diagnosed in individuals between the ages of 20 and 50, though onset can occur in childhood.

Many of the questions asked during the Q & A with Dr. Pederson on June 1, 2008 in Bakersfield revolved around these two disease processes as well as autoimmune diseases such as Rheumatoid Arthritis (RA), Lupus (SLE), Multiple Sclerosis (MS), etc. This e-flash will discuss fibromyalgia and CFS and a subsequent e-flash next week will discuss autoimmune issues.

FIBROMYALGIA / CFS Defined

Fibromyalgia is a difficult, debilitating disorder that truly decreases ones functional capacity. Each person differs in their limitations and their needs. Many individuals believe that this is a psychosomatic problem meaning it is all in ones head! It is imperative to understand that their pain is REAL to them and should not be discounted their lives have been turned upside down. From being diagnosed early in life to during the later years. One can not discount the emotional, physical, and financial ramifications that fibromyalgia and chronic fatigue syndrome have on society.

There is often a great deal of frustration associated with this illness. Given the fact that there are no specific diagnostic tests available to accurately determine whether or not one has fm/cfs, one must identify their own personal subset of symptoms.This illness is not considered to be contagious and it is usually not progressive. The person who suffers usually encounters what are called flares, or a period of time that causes an increase or change in symptoms, pain, etc. It is imperative that an individual who suffers from fibromyalgia/CFS be prepared for these flares and have a game plan in place.

In working with patients clinically, one of the best resources I (Patti) have found is the book Fibromyalgia and Chronic Myofascial Pain: A Survival Manual (2nd Ed.) by Devin Starlanyl and Mary Ellen Copeland. In this book it describes the changes in symptoms that one should be aware of so that they can better be prepared for a flare. Initially I was skeptical about this (from an RN perspective) but over the years I have seen its benefit loud and clear. In addition, I the warning signs to watch for truly are valid even though they vary from person to person.


According to Wikipedia, the defining symptoms of fibromyalgia are chronic, widespread pain and tenderness to light touch. Other symptoms can include moderate to severe fatigue, a heightened and painful response to gentle touch (allodynia), needle-like tingling of the skin, muscle aches, prolonged muscle spasms, weakness in the limbs, nerve pain, functional bowel disturbances,[4] and chronic sleep disturbances.[5] Sleep disturbances may be related to a phenomenon called alpha-delta sleep, a condition in which deep sleep (associated with delta waves) is frequently interrupted by bursts of alpha waves, which normally occur during wakefulness. Slow-wave sleep is often dramatically reduced.

Chronic Fatigue Syndrome

CFS is characterized by significant fatigue that is not improved by bed rest and that may become worse with physical or mental activity. Those with CFS most often function at a substantially lower level of activity than they were capable of before the onset of the illness. In addition, patients report various symptoms, such as weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue lasting more than 24 hours. In some cases, CFS can persist for years (1).

It is important to note that fibromyalgia/CFS does not cause inflammation as does Rheuatoid Arthritis. Therefore, some anti-inflammatory medications may assist in reducing the pain but it does not get to the root of the problem.
Traditional medical therapies for FM/CFS might include anti-depressants, muscle relaxants, anti-seizure medications, central nervous system stimulants, and many more. It is imperative to understand that there is no specific medication that "works" on these illnesses. Therefore, it is of benefit to examine the natural remedies that might be of benefit.

The best way for patients with Fibromyalgia and Chronic Fatigue Syndrome to manage their illness is to schedule their lives and live on a set agenda. When unexpected change occurs, a "flare" usually follows suit.

Natural Therapies

A holistic approach, including managing diet, sleep, stress, activity, and pain is used by many patients. Dietary supplements, massage, chiropractic care, managing blood sugar levels, and avoiding known triggers when possible is the best, most effective way for an individual to make the most of his or her life.

Fibralgia (Stock #4061-6)
Fibralgia is good news for millions of Americans who experience muscle discomfort and fatigue. When the body needs energy-producing fuel, it breaks down muscle protein to create energy. This product contains malic acid and magnesium. It helps support the structural system, especially the muscles. In addition, it provides the body/cells with extra malic acid and magnesium so it won't rob muscle protein to create energy. It also helps with the absorption of several vitamins and minerals to promote bone strength and to regulate nerve impulses.
Malic acid, found naturally in high concentrations in apples and other fruits and vegetables, plays an important role in cellular energy production.
Magnesium is used daily to help with the absorption of several vitamins and minerals, to promote bone strength and to regulate nerve impulses.

IF-Relief (Stock #1175-4)
IF Relief contains a combination of herbal extracts that may support the body's natural process for muscle pain and inflammation relief following exercise and massage. IF Relief contains compounds that may help the body to achieve homeostasis. This formula has a very high ORAC value. It helps support the body's natural process for muscle pain and inflammation relief following exercise and massage. It also contains compounds that may help modulate heat in the body as well as strengthens and protects the immune system.

IF Relief contains turmeric root extract along with mangosteen pericarp extract a source of potent antioxidants called xanthones. The xanthone gammamangostin appears to partially modulate the production of prostaglandins. IF Relief also contains Andrographis paniculata to help modulate certain undesirable responses; boswellia gum extract, which appears to modulate an enzyme that catalyzes leukotriene formation; and white willow bark extract, which contains salicin and appears to modulate the production of prostaglandins.

Flax Seed (Linseed Oil)
(Softgels - Stock #1583-6 Liquid Stock #3162-1)

In recent years there has been increased attention to the use of fish oil in dietary EFA supplementation. Until recently, experts believed the best sources of omega-3 were fish oils. While fish oils are a good source, flax seed oil contains twice as much omega-3 essential fatty acids as fish oil products, without the fishy aftertaste.

Flax seed oil contains both essential fatty acids (linoleic acid and linolenic acid) in large quantities and has an abundance of the more rare linolenic acid. Flax Seed Oil also contains lignans substances known to stimulate immune activity. It is written that flaxseed oil also has anti-estrogen activity which is derived from its fiber, the lignans.

Another name for Flax Seed Oil is that of Linseed Oil. It is important to note that the linseed oil as used in paint is made from flaxseed but as processed and stored and becomes rancid. This is what makes it poisonous to humans (2).

We would like to emphasize that one tablespoon of NSPs Flax Seed Oil equals approximately 14 softgels. Therefore, it is important to assess the desired results and supplement accordingly.

NATURE'S CORTISOL (Stock #3209-4)
Dr. Jacob Teitelbaum, director for the Annapolis Center for Effective FMS/CFS Therapies, states that Evidence suggests that in people with chronic fatigue, the adrenal glands make too much cortisol at night and not enough during the day (3). According to a study published in the Journal of Chronic Fatigue Syndrome, the administration of cortisol could help alleviate symptoms for patients suffering from chronic fatigue syndrome and fibromyalgia. The comprehensive review also showed that the majority of patients could be treated for this adrenal dysfunction with cortisol as part of a multi-system treatment.

This research provides a new understanding that treating the known causes of illness in CFS and FM can improve the symptoms and quality-of-life of patients who suffer from these conditions, Holtorf says. He adds that his research was confirmed in an observational study following the conditions of 500 patients from his clinic where, of the patients given cortisol as part of their treatment protocol, 94 percent showed improvement by the fourth visit, 75 percent noted significant improvement, and 62 percent reported substantial improvement. In addition, by the fourth visit energy levels and a general sense of well-being for patients doubled, Holtorf says. The effectiveness of this multi-system treatment was further confirmed through the analysis of the cumulative findings of more than 40 independent physicians and more than 5,000 patients, the study says (4). In addition, Cortisol treatment carries significantly less risk and a greater potential for benefit than treatments considered to be the standard of care for both conditions, says Holtorf.

Nature's Sunshine describes cortisol as a hormone produced in the adrenal glands in response to stress. It promotes the formation of glucose, which is used as fuel during stressful situations. Nature's Cortisol Formula contains Relora to help the body manage stress and maintain cortisol levels already within the normal range. In addition, it may help with reaction to stress; may help maintain cortisol levels that are already within the normal range; as well as may help maintain blood glucose levels already within the normal range.

Other key ingredients: banaba, holy basil, chromium and vanadium help maintain blood glucose levels already within the normal range. This product also features DHEA, a hormone precursor that interacts with the adrenal glands, and which subsequently may help to lower cortisol production.

Nature's Cortisol Formula also features decaffeinated green tea extract (60% EGCG), l-theanine (supports the body during times of stress) and calcium ascorbate.

RG MAX (Stock #586-3)
It is written that impaired levels of human growth hormone (HGH) could also be a contributing factor to the symptoms of FM/CFS as people with fibromyalgia tend to produce inadequate levels of HGH. It might be interesting to utilize RG-Max to determine whether or not there is a change in the pain level, etc. as our previous research showed that it directly affected the human growth hormone production.

RG-Max is an amino acid drink mix which is designed to help support heart function and blood vessel flexibility. RG-Max contains 10 different amino acids, which are used by the body to help repair and build muscles, including the heart muscle. Improved circulation can help support increased energy and stamina levels and may help support male sexual function. It helps maintain healthy circulation and thereby promotes stamina during exercise. In addition, it protects against premature cardiovascular aging; provides powerful antioxidant benefits; supports heart function and may positively impact blood lipid profiles; contains amino acids that support the heart and skeletal muscles; as well as offers the low-glycemic health benefits of xylitol.

Red grape extract in RG-Max also provides powerful antioxidant benefits, which also protects the circulatory system. All-natural xylitol makes RG-Max taste great without the harmful effects of sugar on the teeth and circulatory system.

RG Max contains xylitol, l-arginine, citric acid, natural strawberry flavor, natural lemon juice, malic acid, silicon dioxide, red grape skin extract, taurine, l-isoleucine, l-leucine, l-methionine, l-tyrosine, l-threonine, N-acetyl-l-cysteine, l-glutamine and acetyl-l-carnitine.

Please do not hesitate to contact us if there is anything we can do to assist you. If you personally have fibromyalgia/cfs, we would love to hear your testimonies.
Fibromyalgia Syndrome and Chronic Fatigue Syndrome are a challenge to work with but remember that together everyone achieves miracles!

We're Here Because We Care!

Health to you naturally!

Chris Ritchason
Patricia Keplinger RN BSN &
The Back to Herbs Team

Works Cited:
1.http://fibrofighters.wordpress.com/2008/03/25/study-cortisol-could-alleviate-fibromyalgia-cfs/
2.Ritchason, Jack. (1996). The Vitamin and Health Encyclopedia. Pleasant Grove, UT: Woodland, p. 74
3. Teitelbaum, Jacob. (2001). From Fatigued to Fantastic. New York: Avery.
4.
http://fibrofighters.wordpress.com/2008/03/25/study-cortisol-could-alleviate-fibromyalgia-cfs/


Categories Fibromyalgia & Chronic Fatigue

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